Meeting children’s mental health needs in school

The Prime Minister, Theresa May, has announced reforms to help children who experience mental health difficulties. The proposals include mental health first aid training for secondary schools which will teach people how to identify symptoms.

Expert analysis from Vivian Hill, Programme Director DEdPsy UCL Institute of Education and Chair of the British Psychological Society’s Division of Educational and Child Psychologists:

“There has been a clear government focus on enhancing children and young people’s mental health within the education sector since 2003. The Social and Emotional Aspects of Learning (SEAL, 2005) and Targeted Mental Health in Schools (TAMHs, 2008), have contributed to the emerging national evidence base of effective interventions (Maxwell et al, 2008). What is clear is that meeting pupils mental health needs is key to ensuring that each individual performs optimally educationally, and this builds their resilience and enables them to make positive transitions across the various stages of the education system, and eventually into the adult world and employment. The Children and Families Bill (2014) and associated Code of Practice have extended SEN support to embrace the 0-25 age range, offering greater support to vulnerable groups, including looked after children, young offenders and those with SEN as they transition into further education, higher education, adulthood and the workforce. However, there has not been a commensurate increase in the training of psychologists to work with increased population.

The increased emphasis on education providers having a mandate to make provision for their learners’ mental health has been most welcome given the considerable underfunding of CAMHs services and the clear evidence of substantial unmet needs within the child and adolescent population. The challenge is to ensure that high quality provision is developed across all phases of education from pre-school to Further and Higher Education and that these are compatible and complementary to the services available through health, providing a seamless range of support suitable for the needs of the local population.

Education providers are meeting this challenge in a range of different ways. In some cases, they have appointed staff to act as learning mentors, and school counsellors, in other cases they are buying in specialist providers, for example educational psychologists (Clark et al, 2016, Weekes et al 2016) or are buying into packages of support from health professionals or independent providers. There is concern about the quality assurance of some of the programmes and the qualifications of those delivering services. It is vital that when making assessments and formulations of mental health needs that suitably qualified staff, with a clear understanding of a wide range of psychological knowledge and expertise are able to ensure that all relevant aspects of the child’s life and functioning are taken into account.

It is unreasonable to make school staff, working from little more than a short period of training, to be responsible for making judgements about something as complex as a young person’s mental health status. It is crucial to ensure timely access to the right types of support. Currently this role is undertaken by applied psychologists, (educational, clinical and counselling) and this should continue to be the case. Every maintained school in England has an attached educational psychologist and it is crucial that when planning with schools to meet pupils’ mental health needs there is clear recognition and acknowledgement of wider systemic issues and that might influence behaviour. Interventions and support packages should be planned to reflect the wider demographic needs of the school population. It is helpful if the psychologist is also aware of what provision is available within the wider community in order to make good use of local community based services and to avoid duplication.

In 2014 the DfE published Mental Health and Behaviour in Schools which aimed: ‘to help schools promote positive mental health in their pupils and identify and address those with less severe problems at an early stage and build their resilience’ The report made clear that children and young people prefer to access support within their school settings and that the most effective interventions included their parents and families.

Over many years now schools have been focusing on the importance of their pupils well-being as a core requirement for optimum learning. With the increased devolution of budgets to schools many have chosen to prioritise targeted interventions to support CYPs mental health, however, with imminent budget cuts it is unclear how schools will be able to protect funding for children’s mental health. Recent research has shown that with fewer centrally provided services and budgets being devolved to schools that developed budgets that support services can become fragmented and that funding for more extreme but lower incidence needs may be compromised.

The British Psychological Society Division of Educational and Child Psychologists are keen to emphasise the presence in the education work force of well qualified experienced educational psychologists. Other applied psychologists including clinical and counselling psychologists can also work in schools. These practitioner psychologists are regulated by the Health Care Professions Council and will have undertaken considerable training in the domain of children and young people’s mental health and have understanding of systemic factors that influence the planning and delivery of services to address mental health and well-being in the school context. Every maintained school will have a linked Educational Psychologist and many other schools and education settings are now choosing to buy in additional time from these services. What is essential is to ensure centrally funded core services to support children’s mental health.

It is important to note that schools have also developed expertise within their existing staffing structures, including the use of learning mentors and voluntary sector providers. It is important that those working within schools to deliver services to support children’s mental health have appropriate expertise and access to adequate supervision. It is not felt that the introduction of new service providers or additional training routes would be an effective use of the limited funding in this area. The BPS feels that increasing the numbers of practitioner psychologists (EPs and CPs) on existing training routes would provide an immediate and cost effective means to enhance services to promote children’s well-being and mental health. Practitioner psychologists are extremely well placed to train, support and supervise school based staff and to advise on, support the development of, and provide appropriate interventions. ”